Change Request
 

NHS Connecting for Health

NHS Data Model and Dictionary Service

Reference: Change Request 1088
Version No:1.0
Subject:NHS Data Model and Dictionary Modelling Changes - Disability
Effective Date:Immediate
Reason for Change:Change to Data Standards
Publication Date:18 January 2010

Background:

The NHS Data Model and Dictionary Service are currently working with the Department of Health and Information Centre for Health and Social Care to develop a number of Data Sets.

During the business analysis stage, it has been identified that these Data Sets cover a number of common areas which are either not currently in the NHS Data Model and Dictionary or amendments are required to make the current information suitable for use in these Data Sets.

This Data Set Change Notice adds the common data items and associated data modelling changes for "Disability" into the NHS Data Model and Dictionary in preparation for these Data Sets. The changes are detailed in the "Summary of changes" below.

The primary purpose is to introduce a new “Disability” and “Disability Severity” Class into the NHS Data Model to support the new data sets currently under development. This will enable the new data sets to use the generic data items and codes for reporting "Perceived" and "Registered" Disabilities and the Severity Level.

These changes do not need to be implemented in end-user systems until the Data Set Change Notices for the specific data sets come into effect. Other specific items will be added to the Data Sets during development.

Summary of changes:

Supporting Information
LEARNING DISABILITY   New Supporting Information
 
Class Definitions
CATEGORY VALUED PERSON OBSERVATION   Changed Description
DISABILITY   New Class
DISABILITY SEVERITY   New Class
 
Attribute Definitions
CATEGORY VALUED PERSON OBSERVATION TYPE   Changed Description
DISABILITY SEVERITY CODE   New Attribute
REGISTERED DISABILITY CODE   New Attribute
REGISTERED DISABILITY END DATE   New Attribute
REGISTERED DISABILITY START DATE   New Attribute
 
Data Elements
DISABILITY SEVERITY CODE   New Data Element
REGISTERED DISABILITY CODE   New Data Element
REGISTERED DISABILITY END DATE   New Data Element
REGISTERED DISABILITY START DATE   New Data Element
 

Date:18 January 2010
Sponsor:Ken Lunn, Director of Data Standards and Products, NHS Connecting for Health

Note: New text is shown with a blue background. Deleted text is crossed out. Retired text is shown in grey. Within the Diagrams deleted classes and relationships are red, changed items are blue and new items are green.

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LEARNING DISABILITY

Change to Supporting Information: New Supporting Information

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

A Learning Disability (formerly known as a Mental Handicap and referred to as an Intellectual Disability) is a type of DISABILITY.

A Learning Disability usually has a significant impact on a PERSON's life. A PERSON with a Learning Disability finds it harder than others to learn, understand and communicate.

People with Profound and Multiple Learning Disabilities (PMLD) need full-time help with every aspect of their lives, including eating, drinking, washing, dressing and toileting etc.

Someone is considered to have a Learning Disability when they function at a level of intellectual ability which is significantly lower than their chronological age. This is usually considered to be equivalent to having an Intelligence Quotient (IQ) of seventy or less:

  • Mild Learning Disability (roughly equivalent to an IQ of fifty to seventy) is comparable to the educational term 'Moderate Learning Difficulty'. It is usually caused by a combination of restricted learning and social opportunities plus a high rate of low to average intellectual ability and Learning Disability in close relatives.

  • Moderate-to-profound Learning Disability (roughly equivalent to an IQ below fifty) is comparable to the educational term 'Severe Learning Difficulty'. It usually has a specific biological cause.

Note: A Learning Difficulty is a type of Special Education Need which affects areas of learning, such as reading, writing, spelling, mathematics etc.

Further information on Learning Disabilities, can be found on the internet, for example:

 

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CATEGORY VALUED PERSON OBSERVATION

Change to Class: Changed Description

This item is being updated for development purposes and the changes have not yet been assured by the Information Standards Board for Health and Social Care.

A type of PERSON PROPERTY.

Observations made regarding a PATIENT. These observations do not include information about a treatment or intervention.

CATEGORY VALUED PERSON OBSERVATION allows coded classifications of observations about a PATIENT, whereas MEASURED PERSON OBSERVATION allows for recording of measurements about a PATIENT.

CATEGORY VALUED PERSON OBSERVATIONS include:

 

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DISABILITY

Change to Class: New Class

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

An indication of whether a PERSON is disabled.

This can be either a:

  • Registered Disability:
    • where a PERSON is registered as disabled with their Local Authority; or

  • Perceived Disability:
    • an indication of whether the PERSON considers themself to be disabled.

Under the Disability Discrimination Act (DDA), a disabled PERSON is defined as "someone who has a physical or mental impairment that has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities". See the Directgov website.

 

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DISABILITY

Change to Class: New Class

Attributes of this Class are:
REGISTERED DISABILITY CODE
REGISTERED DISABILITY END DATE
REGISTERED DISABILITY START DATE

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DISABILITY

Change to Class: New Class

Each DISABILITY
may be the category for one or more CATEGORY VALUED PERSON OBSERVATION
may be classified by one and only one DISABILITY SEVERITY

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DISABILITY SEVERITY

Change to Class: New Class

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

The severity of a DISABILITY for a PERSON.

This could be as stated by a PERSON or as agreed between a PERSON and the CARE PROFESSIONAL.

 

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DISABILITY SEVERITY

Change to Class: New Class

Attributes of this Class are:
DISABILITY SEVERITY CODE

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DISABILITY SEVERITY

Change to Class: New Class

Each DISABILITY SEVERITY
must be classified for one and only one DISABILITY
may be the category for one or more CATEGORY VALUED PERSON OBSERVATION

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CATEGORY VALUED PERSON OBSERVATION TYPE

Change to Attribute: Changed Description

This item is being updated for development purposes and the changes have not yet been assured by the Information Standards Board for Health and Social Care.

One of the related classification Classes listed in the CATEGORY VALUED PERSON OBSERVATION description as a type of this Class.

National Codes:

01ALCOHOL STATUS 
02ASPIRIN THERAPY LOCATION
03BLEED COMPLICATION
04ETHNIC CATEGORY 
05JOINT REPLACEMENT REVISION CLASSIFICATION 
06LANGUAGE CLASSIFICATION 
07LEGAL STATUS CLASSIFICATION 
08PATIENT CLINICAL GROUP 
09PERFORMANCE STATUS 
10PERSON GENDER 
11PERSON MARITAL STATUS 
12SARCOMA PREDISPOSING CONDITION 
13SKIN LYMPHOMA MORPHOLOGY 
14ACCOMMODATION STATUS
15SEXUAL ORIENTATION
16RELIGIOUS OR OTHER BELIEF SYSTEM AFFILIATION
17RELIGIOUS OR OTHER BELIEF SYSTEM AFFILIATION GROUP
18DISABILITY
19DISABILITY SEVERITY
 

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DISABILITY SEVERITY CODE

Change to Attribute: New Attribute

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

The severity of a DISABILITY for a PERSON.

This could be as stated by a PERSON or as agreed between a PERSON and the CARE PROFESSIONAL.

National Codes:

01None
02Mild
03Moderate
04Severe
05Extreme
 

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DISABILITY SEVERITY CODE

Change to Attribute: New Attribute

DISABILITY SEVERITY CODE
 
Data Elements:
DISABILITY SEVERITY CODE

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REGISTERED DISABILITY CODE

Change to Attribute: New Attribute

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

The Registered DISABILITY of a PERSON, as stated by a PERSON.

A PERSON can have more than one Registered DISABILITY.

National Codes:

01Behaviour and Emotional
02Hearing
03Manual Dexterity
04Memory or ability to concentrate, learn or understand (Learning Disability)
05Mobility and Gross Motor
06Perception of Physical Danger
07Personal, Self Care and Continence 
08Progressive Conditions and Physical Health (such as HIV, cancer, multiple sclerosis, fits etc)
09Sight
10Speech
XOther
NNo Registered DISABILITY
ZNot Stated (PERSON asked but declined to provide a response)
 

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REGISTERED DISABILITY CODE

Change to Attribute: New Attribute

REGISTERED DISABILITY CODE
 
Data Elements:
REGISTERED DISABILITY CODE

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REGISTERED DISABILITY END DATE

Change to Attribute: New Attribute

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

The date on which a PERSON ceased to be registered on the DISABILITY Register with their Local Authority.

 

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REGISTERED DISABILITY END DATE

Change to Attribute: New Attribute

REGISTERED DISABILITY END DATE
 
Data Elements:
REGISTERED DISABILITY END DATE

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REGISTERED DISABILITY START DATE

Change to Attribute: New Attribute

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

The date on which a PERSON was registered on the DISABILITY Register with their Local Authority.

 

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REGISTERED DISABILITY START DATE

Change to Attribute: New Attribute

REGISTERED DISABILITY START DATE
 
Data Elements:
REGISTERED DISABILITY START DATE

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DISABILITY SEVERITY CODE

Change to Data Element: New Data Element

Format/Length:an2
HES Item: 
National Codes:See DISABILITY SEVERITY CODE
Default Codes: 

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.  

Notes: 
DISABILITY SEVERITY CODE is the same as attribute DISABILITY SEVERITY CODE.

 

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DISABILITY SEVERITY CODE

Change to Data Element: New Data Element

DISABILITY SEVERITY CODE
 
Attribute:
DISABILITY SEVERITY CODE

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REGISTERED DISABILITY CODE

Change to Data Element: New Data Element

Format/Length:an2
HES Item: 
National Codes:See REGISTERED DISABILITY CODE
Default Codes: 

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.  

Notes: 
REGISTERED DISABILITY CODE is the same as attribute REGISTERED DISABILITY CODE.

 

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REGISTERED DISABILITY CODE

Change to Data Element: New Data Element

REGISTERED DISABILITY CODE
 
Attribute:
REGISTERED DISABILITY CODE

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REGISTERED DISABILITY END DATE

Change to Data Element: New Data Element

Format/Length:see DATE
HES Item: 
National Codes: 
Default Codes: 

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

Notes: 
REGISTERED DISABILITY END DATE is the same as attribute REGISTERED DISABILITY END DATE.

 

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REGISTERED DISABILITY END DATE

Change to Data Element: New Data Element

REGISTERED DISABILITY END DATE
 
Attribute:
REGISTERED DISABILITY END DATE

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REGISTERED DISABILITY START DATE

Change to Data Element: New Data Element

Format/Length:see DATE
HES Item: 
National Codes: 
Default Codes: 

This item is being used for development purposes and has not yet been assured by the Information Standards Board for Health and Social Care.

Notes: 
REGISTERED DISABILITY START DATE is the same as attribute REGISTERED DISABILITY START DATE.

 

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REGISTERED DISABILITY START DATE

Change to Data Element: New Data Element

REGISTERED DISABILITY START DATE
 
Attribute:
REGISTERED DISABILITY START DATE

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For enquiries about this Data Set Change Notice, please email datastandards@nhs.net